经食管超声心动图用于手术治疗儿童房室瓣疾病  

Transesophageal echocardiography for surgical therapy of pediatric atrioventricular valve diseases

作　　者：钱晶晶[1,2,3] 叶菁菁[1,2,3] 俞劲[1,2,3] 赵镭[1,3] 傅行鹏 张宝富 程俞婷 王涵 QIAN Jingjing;YE Jingjing;YU Jin;ZHAO Lei;FU Xingpeng;ZHANG Baofu;CHENG Yuting;WANG Han(Department of Ultrasound,Children's Hospital,Zhejiang University School of Medicine,Hangzhou 310052,China;Heart Center,Children's Hospital,Zhejiang University School of Medicine,Hangzhou 310052,China;National Clinical Research Center for Child Health,Children's Hospital,Zhejiang University School of Medicine,Hangzhou 310052,China)

机构地区：[1]浙江大学医学院附属儿童医院超声科,浙江杭州310052 [2]浙江大学医学院附属儿童医院心脏中心,浙江杭州310052 [3]浙江大学医学院附属儿童医院、国家儿童健康与疾病临床医学研究中心,浙江杭州310052

出　　处：《中国医学影像技术》2024年第7期982-985,共4页Chinese Journal of Medical Imaging Technology

摘　　要：目的观察经食管超声心动图(TEE)用于手术治疗儿童房室瓣疾病的价值。方法回顾性分析273例接受体外循环下手术治疗的房室瓣疾病患儿,均于术前1周内接受经胸超声心动图(TTE)检查、于手术前后接受TEE,根据TEE判断是否需修正TTE诊断结果并评估疗效;以手术所见为标准,比较术前超声诊断符合率。结果对273例均顺利完成TEE检查,术前TTE诊断符合率为83.88%(229/273);根据TEE对44例(44/273,16.12%)TTE诊断结果加以补充或修正后,术前超声诊断符合率达100%(273/273),高于单一术前TTE(P<0.001)。术后TEE发现5例残余分流、3例瓣膜反流改善不明显,予以相应处理后再次复查TEE显示疗效满意。结论TEE可于术前准确诊断儿童房室瓣疾病、术后评估手术疗效,具有重要临床应用价值。Objective To explore the value of transesophageal echocardiography(TEE)for surgical therapy of pediatric atrioventricular valve diseases.Methods Data of 273 children with atrioventricular valve diseases who underwent surgical operation under extracorporeal circulation were retrospectively analyzed.Transthoracic echocardiography(TTE)was performed within 1 week before,while TEE was performed before and after surgical operation.Whether TTE diagnosis should be adjusted were evaluated according to findings of TEE,so were the effects of surgical treatments,and the ultrasonic diagnostic coincidence rate before operation were compared taken surgical findings as standards.Results TEE was successfully completed in all 273 children.The diagnostic coincidence rate of preoperative TTE was 83.88%(229/273).After adjustment or supplement according to TEE in 44 cases(44/273,16.12%),the ultrasonic diagnostic coincidence rate reached 100%(273/273),higher than that of preoperative TTE alone(P<0.001).Residual shunt was found in 5 cases,while no obvious improvement of valvular regurgitation was noticed in 3 cases with post operative TEE,and after corresponding treatments,re-examination of TEE showed satisfactory efficacy in all the above cases.Conclusion TEE could be used to accurately diagnose pediatric atrioventricular valve diseases before and evaluate the efficacy after surgical treatments,having important clinical application value.

关 键 词：儿童 心脏瓣膜病 超声心动描记术 经食管 

分 类 号：R726.1[医药卫生—儿科] R445.1[医药卫生—临床医学]